Social context explains race disparities in obesity among women

Bleich, Sara N.; Thorpe, Roland J.; Sharif-Harris, Hamidah; Fesahazion, Ruth G.; LaVeist, Thomas A.

doi:10.1136/jech.2009.096297

Cited by 118 publications

(88 citation statements)

References 43 publications

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“…27 In fact, prior EHDIC analyses found minimal racial disparities in hypertension, obesity and diabetes, and those findings are largely attributable to relatively high disease prevalence in whites. [28][29][30] Secondly, income, which is a consistent predictor of hypertension elsewhere, 27,31 was not associated with blood pressure levels or with risk of hypertension in this sample. This is likely because the community mean income is near the poverty threshold and there is little variability in income, so poverty exposure is homogeneous within the sample.…”

Section: Discussionmentioning

confidence: 56%

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Samuel

Thorpe²,

Bower³

et al. 2015

J Urban Health

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Community problems have been associated with higher, and community resources and social cohesion with lower, blood pressure. However, prior studies have not accounted for potential confounding by residential racial segregation. This study tested associations between community characteristics and blood pressure levels and prevalent hypertension in a racially integrated community. The Exploring Health Disparities in Integrated Communities Study measured blood pressure in residents of two contiguous racially integrated and low-income US Census Tracts. Community characteristics included a standardized community problem score and binary indicators for community social cohesion, having a community leader available, and having at least one community resource observed on the participant's block. In adjusted models, greater community problems and proximity to resources were associated with lower systolic (β=−2.020, p=0.028; β=−4.132, p=0.010) and diastolic (β=−1.261, p=0.038; β=−2.290, 0.031) blood pressure, respectively, among whites (n=548). Social cohesion was associated with higher systolic (β=4.905, p=0.009) and diastolic blood pressure (β=3.379, p=0.008) among African Americans (n=777). In one racially integrated lowincome community, community characteristics were associated with blood pressure levels, and associations differed by race. Directions of associations for two findings differed from prior studies; greater community problem was associated with lower blood pressure in whites and community social cohesion was associated with higher blood pressure in African Americans. These findings may be due to exposure to adverse environmental conditions and hypertensive risk factors in this low-income community.

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Section: Discussionmentioning

confidence: 56%

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Samuel

Thorpe²,

Bower³

et al. 2015

J Urban Health

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“…In a low-income community of Baltimore, MD, for example, no racial disparities in obesity have been reported among white and black women sharing similar socioeconomic status (Bleich and Thorpe, 2010). This finding points to a notion that social-environmental factors rather than individual characteristics such as race should be given greater priority in the study of obesity, and that large-scale societal aspects of the environment may influence obesity outcomes (Zhang and Wang, 2012).…”

Section: Introductionmentioning

confidence: 64%

The food environment and adult obesity in US metropolitan areas

Michimi

Wimberly

2015

Geospat Health

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This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

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“…4,5 The drivers of the positive energy balance (driven by either too much energy intake or too little energy expenditure) are increasingly being identified in the environment. [6][7][8][9] As a result, recent trends in research, in the United States and other developed countries, emphasize the use of community-based settings as an important strategy for preventing obesity. This shift toward a stronger community focus is echoed by the recent Institute of Medicine report Accelerating Progress in Obesity Prevention, which recommends a comprehensive approach to childhood obesity prevention that includes the community.…”

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confidence: 99%

Systematic Review of Community-Based Childhood Obesity Prevention Studies

et al. 2013

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OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS:We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials. gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer' s data abstraction for completeness and accuracy.RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non-randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS:The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. Pediatrics 2013;132:e201-e210 AUTHORS:

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Social context explains race disparities in obesity among women

Cited by 118 publications

References 43 publications

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

The food environment and adult obesity in US metropolitan areas

Systematic Review of Community-Based Childhood Obesity Prevention Studies

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